Herbal Sports Cream:
Pain Killer, Magical Cure, Or a Placebo Effect?

Tom
Hildebrandt

The
Internet’s size and easy access for consumers encourages small businesses to
provide information about their products in addition to the common
overabundance of imagery and advertising slogans.However, this information is not always accurate or patrolled for
misleading or incorrect assumptions.The goal of this paper is to examine Epicure Crystal Sports Cream, a
sore muscle/weightlifting aid, and the claims made about it on the web (www.choicemail.com/epicure).In addition to the claims made about this
particular product, each active ingredient has a literature provided by the
large number of alternative medicine and herbal specialist sites on the
Web.After describing this consumer
information, I will provide you with a survey of the clinical research that
supports, denies, or falls short of these claims.

There
are several active ingredients reported by the “specialists” at Epicure: Bellis
Perennis (Daisy), Calendula Officinalis (Garden Marigold), Echinacea
Angustifolia (Cone Flower), Symphytum Officinale (Comfrey), Aconitum
Napellus (Aconite), Arnica Montana (Leopard’s Bane Root). Hypericum
Perforatum (St. John’s Wort), Ledum Palustre (Wild Rosemary), and Ruta
Graveolens (Rue).Each of these
ingredients comprises a cream that “conquers pain from sports related or other
injuries which might otherwise lead to a missed workout” (www.choicemail.com/epicure).Among the other claims provided by Epicure
are relief of “sports injuries, pain, minor inflammation of various origins,
sprains, strains, discomforts, and bruises” (www.choicemail.com/epicure).This product, because of its claims and apparent
success is currently involved in a clinical study guided by Prodigy, Inc., at
the Vanderbilt University Sport’s Medicine Center.However, this project is not yet completed and the results are
not available to report.It is for this
reason that the best examination of the product is to research each of the
active ingredients for potential success in application for the above-mentioned
ailments.

The
Internet provides countless web sites where one can learn about the various
ingredients of Epicure Crystal Sports Cream.Bellis Perennis, more commonly known as daisy, has an interesting
literature on the Web.Once called
“Bruisewort,” by 14th Century healers, this flower is well known for
it ability to help cure fresh wounds, gout, or fever (www.botanical.com/botanical/mgmh/d/daisyc03.html).Other sources report that daisy is best used
for arthritis, rheumatism, diarrhea, liver and kidney problems (www.virtualciti.com/sushruta/pages/researcher.htm).Certain circles of alternative medicine also
believe that these flowers have a more religious healing power and are best
used on a different level.For
instance, daisy is thought to calm abusive households and help in war;
additionally, daisy is good for the sudden shock, trauma, or head trauma
associated with these environments (www.medicinegarden.com/ne/bellis_perennis.html).Strangely, I found very few places that
claimed daisy was a useful treatment for sports related complaints.In fact, the only site that claimed daisy as
a useful treatment in sports problems simply stated that daisy had an “affinity
for sore muscles” (www.mothernature.com/ency/Homeo/Athletic_Support_hm.asp).

Calendula Officinalis or the Garden
Marigold, as reported on the Web, cures many types of pain.As with daisy, Marigold is best used to heal
wounds and bruises; but other reported uses include headaches, earaches, and
fever (www.kcweb.com/herb/herbmain.htm).In addition to pain relief, this flower
kills bacteria and fungus on the skin (www.vineherbal.com.html).Marigold has religious uses such as
increasing energy of the environment as well as the user (www.mothernature.com/ency/Herb/Calendula.asp).Finally, this cure-all flower is good for
treating minor burns, reducing swelling and curing skin disease (www.mothernature.com/ency/Herb/Calendula.asp).Part of these reported effects originate
from the high flavonoid content of marigold, which is a “natural”
anti-inflammatory (www.mothernature.com/ency/Herb/Calendula.asp).Although the reported effects of this flower
seem applicable to sports injuries, no sites reported specific uses for sports
medicine.This could be because
marigold is not as effective as other herbal aids in curing common pains
associated with sports, or because marigold’s curative powers are so broad as
to be assumed as applicable to sports related discomfort.

Echinacea
Angustifolia or Cone Flower is thought of as one of the wonder drugs in
herbal medicine.Many people take this
supplement orally to fight diseases such as the flu, cold, or strep
throat.However, it can also be used
topically for treating eczema, burns, canker sores, herpes, vaginitus, or
abscesses (www.pharmor.com/index_vit_spec.html).The Cone Flower has an interesting past as
plains Indians reportedly used it topically to treat insect and snake bites,
toothaches, wounds, mumps, small pox, and measles (www.kcweb.com/herb/herbmain.htm).In 1887 this herb made it to American
Medicine as a treatment for syphilis and the common cold (www.mothernature.com/ency/Herb/Echinacea.asp).
However, the recent jump in popularity has brought a more informative nature to
discussion of this herb on the Web.One
site dedicated to accurate information about herbs reports the components of
Echinacea to be “essential oil, polysaccharides, poluacetylenes, betain,
glycoside, sesquiterpenes and caryophylene.In addition to these complex biologic constituents, Echinacea contains
copper, iron, tannis, protein, fatty acids, and vitamins A, C, and E.This site continues by claiming that recent
research shows that Echinacea can improve the migration of white blood cells to
foreign microorganisms (www.kcweb.com/herb/echin.htm).

Despite
the large amount of information on Echinacea taken as an oral supplement, very
little exists on the Web describing Echinacea’s properties when applied to the
skin.Some sites mention that Echinacea
has use topically, but few expound upon these uses.However, this is a trend that appears repeatedly throughout the
Internet literature on herbs.

Symphytum
Officinale or Comfrey is not mentioned as routinely as many other herbs on
most Web sites.It is most commonly
know for its blood cleansing properties, but is reportedly used to treat
swelling, cramps, tuberculosis, pain and burns (www.healthrise.com/pr/herb_cd.html).However useful, this herb taken orally can
cause liver damage (www.healthrise.com/pr/herb_cd.html).In fact, one site warned that Comfrey should
not be taken until further evidence of its safety can be established (www.pharminfo.com/pubs/pnn/pnn37_3.html).Other reported uses include wounds, sores,
bruises, broken bones, and sprains (www.wic.net/waltzark/herbencc.htm).Religiously, this herb will bring good luck
to the user, but must only be used externally or your luck will become bad (www.wic.net/waltzark/herbencc.htm).Like many of the other ingredients in
Epicure Crystal Sports Cream, there appears to be little other than the common
use to treat pain that would justify the herbal concoction reported Epicure.

Although
Comfrey is scarcely discussed on many herbal sites, Aconitum Napellus or
Aconite is even less popular.Some
circles refer to Aconite as “monkshood” because of the shape of the
flower, which appears to be protective (www.medicinegarden.com/ne/aconite.html).It is recommended to be taken orally when
feeling anxious, fearing death, heavy head, vertigo, dry mouth, gums are
inflamed, red eyes, chest pressure, throat irritation or experiencing chills (www.medicinegarden.com/ne/aconite.html).
Interestingly, there were no sites that
described this herb’s uses in topical treatment.Although, this may be due to Aconite’s lack of discussion
of the Web in general and not due to unreported use of the herb as an external
remedy.

Among Epicure Crystal Sports Cream’s
ingredients is the perhaps the most talked about herbal remedy on the Internet;
Hypericum Perforatum or St. John’s Wort is a well known treatment for
mild depression, although that statement has yet to be proven by rigorous
clinical study.Despite the large
discourse on St John’s Wort, many sites disregard its uses in external
treatment.Some claim that St. John’s
Wort is a great treatment for wounds or burns, but do not discuss why an
anti-depressant would work in such a way (www.pharmor.com/index_vit_spec.html).Reportedly, this herb’s 2,400-year safe
history includes external uses such as ulcers, arthritis, menstrual cramping,
sprains, bruises and varicose veins (www.kcweb.com/herb/stjohn.htm).The reason for the many wide-ranging
curative properties of this plant derives from its more than 50 active
ingredients (www.kcweb.com/herb/stjohn.htm).These include hypericin, pseudohypericin,
flavonoids, tannis, and procyanidins (www.kcweb.com/herb/stjohn.htm).However, the only reported side-effect to
any sort of use of this herbal remedy was photosensitivity, so it is thought to
be a very safe treatment (www.kcweb.com/herb/stjohn.htm).

Ledum Palustre or Rosemary is a common cooking aid
and is discussed as both a culinary and healing tool.The most common uses as an external healing agent, which were
repeated on many web sites, include stimulating the circulatory system,
treating insect bites and stings, arthritis, and muscle pain (www.wic.net/waltzark/herbencc.htm).Religiously, Rosemary is thought to be a
bodily protector or in some cases used to banish unwanted people or spirits (www.wic.net/waltzark/herbencc.htm).

The
result of a web search on the nine active ingredients listed under Epicure’s
herbal sports cream leaves a lot of unanswered questions.Although most of these herbal information
sites reveal success with treating general aches, pains, and bruises, they do
not direct the consumer to use the products for sports related injuries.In addition, none of the sites surveyed
revealed any possible interaction effects among the different herbs.For the safety of the consumer, this is an
important topic.When evaluating
comments on the Web, it is important to look at the reliable information that
supports these claims.The second half
of this paper is intended to give a review of the scientific evidence of the
Internet statements described previously.

PART II

A
review of scientific literature proved ineffective in supporting the claims
suggested by Internet literature describing Bellis perennis.Research that may or may not contribute to
any such claims about this plant result from European research and were not
able to be translated for report here.However, I will give a brief description of the translated abstracts
obtained on MEDLINE.Avato et al.
(1997) report that the essential oil of the common daisy has two components
that show some degree of “antimicrobal activity”.These compounds are deca-4, 6-diynoic acid and deca-4, 6-diyne-1,
10-dioic acid.Based on the information
in the abstract, no concrete claims about possible anti-bacterial effects can
be made.A separate study tested the in
vitro and in vivo antifungal properties of Bellis perennis, but the
results are unable to be discussed here (Desevedavy et al 1989).Because of the uncertain amount of
literature and the inability to analyze it critically, this herb remains a
mystery and that should be considered when using any product which uses it.

Calendula
officinalis has a breadth of literature, which suffers from similar
translation and availability problems as the common daisy.Despite these restrictions, Park et al.
(1998) report that lutein from Marigold extract can reduce breast tumor
development.Using mice bread with for
developing a certain type of mammary tumor and a separate group inoculated with
tumor cells (n=20/treatment), the authors compared different diets containing
0.002, 0.02, 0.2, and 0.4 % lutein from Marigold extract.The results showed that the lower doses
(0.002-0.02%) significantly lowered tumor incidence at a P<0.05 level.This study hints at a potential cancer
fighting agent in Marigold extract, but this is not mentioned in the Internet
literature.In addition, this study
uses Marigold taken orally as opposed to used topically.This prevents any generalization to the
ingredient found in Epicure Crystal Sport Cream.

Other
studies on Marigold’s healing properties suggest that it can reduce reverse transcription
of HIV-1 in controlled cell cultures (Kalvatchev et al. 1997).However, this has not been proven in human
trials.Research on Marigold’s
anti-inflammatory effects does exist, but these articles could not be
obtained.Loggia et al (1994) report
that triterpenoids are effective in reducing inflammation, but Calendula
officinalis has many active components (Abstract).In addition to its healing properties,
Marigold has been shown to genotoxicity in heterozygous diploid D-30 of
Aspergillus nidulans (Ramos et al 1998).This has no generalizing effects to humans, but is an example of the
potential danger observed with Calendula officinalis.In conclusion, Marigold may be an important
active ingredient in Epicure Crystal Sports Cream by providing
anti-inflammatory effects, but other assumptions made about the herb lack
significant research.

On
of the most popular and most researched herbs on the ingredient list for
Epicure’s sports cream is Echinacea.However, researchers are more interested in the effects of this drug
when taken orally.Several review
articles include discussion of this herb and its potential hepatoxicity (Hill
and Van Haselen 1996; Miller 1998; Ness et al. 1999).This is of particular importance to those who use steroids because
it may increase the risk of hepatoxicity (Miller 1998).Hill and Van Haselen (1996) examined the
effects of Prrrikweg gel on insect bites.This homeopathic gel includes Echinacea and Ledum Palustre, which
are both ingredients in Epicure’s sports cream.The study demonstrated that this gel is unable to relieve
itching, but the methodological design of the experiment cannot be
evaluated.Final evaluation of this
herb is that not much is known about how it affects humans when applied
topically. However, since there are some athletes who use steroids, any product
that contains this herb should be considered an increased risk to hepatoxicity.

Little
research exists on Comfrey and its efficacy in treating pain or swelling.Hirono et al. (1978) reports that the
pyrrolizidine alkaloids in Symphytum officinale increase the rate of
tumors when fed to rats as compared to controls.In all conditions of experimental group, 3 groups eating
different parts of the plant (leaf, stem, and root), there was an increased
rate of tumors.No studies were found
that discussed the topical treatment, human subjects, or efficacy of the
herb.This herb has no standing for its
claims and could poses potential cancer causing agents.

Aconitum
Napellus may be widely used by homeopaths but there are some side effects
to its use.According to Ameri(1998) the most active components in this
herb are the Aconitum Alkaloids.These components activate voltage gated NA+ channels and block the
reuptake of adrenaline.This causes an inexcitability
and suppression of pain transmission at the neuronal level.However, too much of this can be toxic.The author suggests that the next important
step to studying this herb is to develop a dose dependent curve for
neurotoxicity, which will better allow physicians and homeopaths to understand
what dosages are safe.As with the
other Epicure ingredients, this drug has no substantial literature to link it
to treating sports injuries, or to support the various other curative
suggestions mentioned on the Web.

Ernst
and Pittler (1998) reviewed the efficacy of homeopathic Arnica, which is
the most frequently studied placebo-controlled herbal remedy.Of the eight studies reviewed, all had
severe methodological flaws that prevent any concrete conclusions.Many of these shortcomings include high
dropout rates, no randomization, or extremely small sample size.The authors conclude that the curative use
of Arnica Montana for sore muscles, pain, or trauma is not justified in
the scientific literature. In addition,
both Kaziro (1984) and Hart et al (1997) report an increased swelling and pain
in patients who just had their wisdom teeth removed and no effect on abdominal
hysterectomy recovery respectively.Both of these studies were double-blind, placebo controlled studies and
provide the best methodological evidence for any curative effect of
Arnica.Additionally, Vickers et al.
(1998) reported no effect for decreasing pain 400 long distance runners in a
randomized, double-blind, placebo controlled trial.Because this plant seems to provide mixed results in clinical
studies and is not viewed by the scientific literature as providing significant
scientific evidence for its use, it’s use in Epicure’s sports cream remains
unjustified.

St
John’s Wort has a similar place to Echinacea in the scientific literature;
there is an abundance of studies that report the effects of this herb when
taken orally, but very little when administered via the skin.Ness et al. (1997) reviewed the literature
on St. John’s Wort and concluded that it is effective in treating mild
depression to the factor of 2.7 x more than placebo, but it may have the side
effects of dizziness, dry mouth, fatigue, constipation and nausea.No studies of topical treatment were
discussed, and none were found.In
light of this finding, one must again question the justification of its
inclusion in Epicure’s sports cream.

Rosemary
and Rue are not adequately discussed in the scientific literature.Only one abstract was located which reported
that alopecia areata was treated successfully by an essential oil of
rosemary.However, this study had a low
sample size (n=8) and the dermatologists who applied the procedures were not
blind.In addition, Hill and Van
Haselen (1996) reported the ineffectiveness of a gel with Rosemary to relieve
the itching of an insect bite.I found
no applicable studies relating to Rue that could be discussed here.

The
conclusion of this review of scientific literature is that it is scarce,
diverse, and generally unsupportive of any justification in the use of
Epicure’s sports cream or the sister claims made by herbal sites on the
Internet.Whenever using a herbal
remedy or cure, be sure to consult a physician or be extremely critical of the
research and/or claims made on the Internet.They remain unmonitored and lack control of the Federal Drug
Administration (FDA).If you are
considering using Epicure Sports Cream, be aware of the lack of scientific
evidence supporting Epicure’s claims and be sure to consider the possible
adverse effects associated with the ingredients.